Objective To investigate the relevance between the times of cytokine-induced killer cell (CIK cell) adoptive immunotherapy and the survival of the elderly patients with gastric cancer.Methods Lymphocyte separation medium was used to isolate mononuclear cells, and then the cultured CIK cells were infused back into the patients with gastric cancer. A retrospective cohort study was adopted by using Kaplan-Meier to estimate median survival time and survival rate, using Log-rank test to analyze the impact of clinical factors on survival rate, and using RR and 95% CI to estimate the contact intensity of death outcome, survival time and CIK cell treatment. Results There were nostatistically significant differences in gender,age, tumor site, histological type, invasion depth, lymph node metastasis, pathological grade, tumor size or tumor distribution between chemotherapy group and CIK treatment group (all P＞0.05). The median survival time of patients with gastric cancer was significantly longer in CIK treatment group than in chemotherapy group (61 vs. 21, χ2=10.215, P=0.001). Compared with the patients treated by chemotherapy alone, the increased times of CIK treatment induced more survival rate and 2-5 years life spans (χ2=12. 461, P=0.006). Conclusions With the treatment that CIK cells are infused back into the elderly patients with gastric cancer, the risk of death is reduced, and the lifespan is prolonged, which is associated with the CIK cell treatment times.

Objective To study the in vitro anti-tumor activity of dendritic cells (DCs) loading with antigen produced by radiofrequency ablation of tumor lysate in situ combined with cytokine-induced killer cells (CIK).Methods CIK ceils derived from BALB/C mouse spleen and DCs derived from bone marrow were prepared,and experimental model of murine colon carcinoma were established for radiofrequency ablation.The supernatant of tumor tissue in situ lysis after repeated freezing and thawing were tested by lowry protein quantitative statutory,amounting to a final concentration of 5 μg/ml,then load to the first 5 days of culture DCs (Ag-DC),2 days later,co-cultured with CIK cells after the first seven days of culture 48 h (Ag-DC-CIK).Flow cytometry was used to analyze costimulatory molecules on the surface of the cells,and CCK-8 assay to detect in vitro cytotoxic activity.Results The DCs loading with antigen resulted in an increase in the proportion of CD86 + CD11 c +,MHC Ⅱ + CD11 c + and MHC Ⅱ + CD80 + cells.The main effector cells of CIK cells were CD3 + NK1.1 + cells.The percentage of CD3 + NK1.1 + cells was 1.45％ on the first day of the culture ; while when they had been cultured for 7 days,the percentage CD3 + NK1.1 + significantly increased to 36.9％.The cytotoxicity of Ag-DC-CIK cells toward C26 cells was much more efficient than that of DC-CIK,CIK cells.The cytotoxic activity of the former was significantly lower than the latter and the same target ratio.When the ratios of effector cells to target cells were 5 ∶ 1,the cytotoxic activity of Ag-DC-CIK cells against C26 cells was (74.9 ± 3.5) ％,; while the DC-CIK was (71.2 ± 2.1) ％ and the CIK cells was (68.7 ± 2.9) ％.The difference was statistically significant(F =7.007,P =0.007).When the ratios of effector cells to target cells were 10 ∶ 1,the cytotoxic activity of Ag-DC-CIK cells against C26 cells was (82.3 ± 4.5) ％,while the DC-CIK cells was (77.1 ± 5.1) ％,and the CIK cells was (72.7 ± 2.8) ％.The difference was statistically significant (F =7.727,P =0.005).When the ratios of effector cells to target cells were 20 ∶ 1,the cytotoxic activity of Ag-DC-CIK cells against C26 cells was (83.2 ± 1.9) ％,while the DC-CIK cells was (77.2 ± 4.2) ％,and the CIK cells was (73.0 ± 2.6) ％.The difference was statistically significant (F =16.594,P =0.000).Conclusion DCs loading with antigen produced by radiofrequency ablation of tumor in situ pyrolysis products can improve in vitro cytotoxic activity combined with CIK cells,which can provide a new comprehensive cancer treatment strategy.

Refractory wounds are the common complication of diabetes,and the therapeutic scheme and methods are paid more and more attention nowadays. The influence of traditional Chinese medicines on diabetic wound healing, such as promoting fibroblasts proliferation, enhancing granulation tissue formation, increasing the secretion of growth factors and reducing the wound scar, was re-viewed in the paper to provide scientific basis and reference for traditional Chinese medicines used in diabetic refractory wounds.

Objective:To review and analyze the prescriptions for Chinese herbal pieces in an integrative traditional Chinese and western medicine hospital to explore the trend and problems in clinical application for Chinese herbal medicines and provide reference for dispensing in pharmacy of traditional medicine and rational drug use. Methods: Totally 1200 prescriptions for Chinese herbal pieces in our hospital were surveyed from January to December in 2014. The irrational use was analyzed, and reasonable suggestions were provided for the clinical application. Results:The problems in the prescriptions for Chinese herbal pieces included uncompleted diagnosis,incompatible diagnosis and medication,nonstandard Chinese name,unclear footnote,irrational usage or dosage and incompati-bility. The prescriptions including above 15 varieties of Chinese herbal pieces in one accounted for 65. 70%, and those with average dose above 250 g accounted for 40. 25%. Conclusion:Regular inspection and quality supervision on the prescription for Chinese herb-al pieces should be strengthened to improve the quality of prescriptions and guarantee the safety and economy of the medication.

Objective To evaluate the clinical efficacy and adverse effects of brucea javanica oil emulsion combined with DP chemotherapy in treating advanced non-small-cell lung cancer.Methods Totally 48 patients with advanced non-small-cell lung cancer were divided into two groups randomly by mechanical sampling method.Twenty-four cases in treatment group were treated by brucea javanica oil emulsion combined with DP chemotherapy, while 24 cases in control group were treated by DP chemotherapy only.The clinical effects were evaluated after treatment of two cycles.Results The short-term effective rate was 54.2% (13/24) in treatment group and 45.8% (11/24) in control group, and there was no significant difference between two groups ( χ2 = 0.333, P = 0.564).The rate of increased and stable life quality was 87.5%(21/24) in treatment group and 58.3%(14/24) in control group,and there was significant difference between two groups (χ2 = 5.169,P = 0.023).The rate of increased and stable weight was 79.2% (19/24) in treatment group and 45.8%( 11/24) in control group, and there was significant difference between two groups (χ2 = 5.689,P = 0.017).The incidence of nausea or vomiting was 45.8% (11/24) in treatment group and 41.7%( 10/24 ) in control group, and there was no significant difference between two groups (χ2 = 0.085, P = 0.771 ).Compared with those in control group, patients in treatment group had less adverse effects in decreasing of peripheral blood leucocytes and showed better immune function.Conclusion Brucea javanica oil emulsion combined with DP chemotherapy in treating advanced non-small-cell lung cancer has good clinical effect, especially enhances the quality of life, improves immune function and decreases the adverse effects of chemotherapy.

OBJECTIVE:To reduce the error rate of homing the withdrawn drugs in pharmacy intravenous admixture service (PIVAS). METHODS:Using risk priority(RPN),the potential failure modes for links of homing the withdrawn drugs in PIVAS were evaluated by using failure mode and effects analysis (FMEA) method. Combining with the links of homing the withdrawn drugs,the reasons for errors were investigated,the feasible scheme to reduce error rates was proposed and the intervention effect was evaluated after 3 months. RESULTS:In the PIVAS links of homing the withdrawn drugs,8 high-risk failure modes had been found in total,such as poor double check system(RPN was 100),unfamiliarity of seemingly drugs(RPN was 36),a large num-ber of the withdrawn drugs(RPN was 20),etc. Thus,risk control measures had been formulated,including reinforcing the double check system,optimizing the management system of PIVAS and so on. After 3 months of intervention management,RPN of the first 3 items were reduced to 20,16,8;error rate of homing the withdrawn drugs was reduced from 1.98% to 0.62%(P<0.05). CONCLUSIONS:The application of FMEA management method in PIVAS of our hospital has reduced the error rate of homing the withdrawn drugs.

Objective To construct a prognostic nomogram for predicting the prognosis of patients with colorectal cancer ( CRC) , and verify its accuracy. Methods The clinical pathologic data from 438 CRC patients hospitalized in the Third Affiliated Hospital of Soo-chow University during January 2006 and May 2013 were retrospectively analyzed. The independent risk factors for predicting the prog-nosis of CRC were determined by the univariate and multivariate regression model. The prognostic nomogram was established by the R-language software. Then, the nomograms of postoperative 3-year and 5-year disease free survivals ( DFS) were drawn, and compared with the actual status. The internal validation and accuracy of the nomogram were determined by the Bootstrap method and the calculat-ed concordance index ( C-index) , respectively. The sensitivity and specificity of the nomogram for predicting the 3-year and 5-year DFS were compared with those of TNM system established by the American Joint Committee On Cancer (AJCC) (7th ed.) by using the time-dependent ROC curve. Results Among 438 CRC patients, the metastasis of CRC occurred in 233 patients, including 105 liver metas-tasis and 57 lung metastasis. Multivariate COX regression analysis showed that tumor differentiation degree, TNM stage, serum CEA level, serum CA19-9 level, neutrophil lymphocyte ratio ( NLR) and P53 level were the independent risk factors of CRC. The C-index of the constructed nomogram for predicting the survival rate of CRC patients was 0.678. The predicted 3-year and 5-year DFS by the no-mogram were highly coincident with the actual status. The analysis results of the time-dependent ROC curve showed that the sensitivity and specificity of the established nomogram for predicting the postoperative 3-year and 5-year DFS were higher than those of AJCC-TNM stage.Conclusion The established nomogram may accurately predict the prognosis of CRC patients, which may be helpful for clinicians to follow up or make beneficial treatment for CRC patients.

Objective To investigate the feasibility of the highGresolution MRI (HRGMRI)in diagnosing the intracranial artery dissection (IAD)and to improve radiological diagnostic accuracy in clinical practice.Methods The clinical data and imaging data of 43 patients with suspected IAD were analyzed retrospectively.HRGMRI and DSA examinations were performed.HRGMRI images were reviewed by two experienced radiologists independently,and DSA images were analyzed by a neurosurgeon.FollowGup durations were from 3 months up to 12 months,and then the clinical diagnoses of IAD were made.The sensitivity,specificity,positive predictive value (PPV),and negative predictive value (NPV)of HRGMRI were calculated,and the consistency of HRGMRI and DSA in the diagnosis of IAD was made.Results 32 over 43 patients were detected to be positive by HRGMRI,however,34 of 43 patients were diagnosed as IAD clinically.The sensitivity and specificity of HRGMRI for detecting IAD were 9 1.2% and 88.9%,respectively.The PPV was 96.9%,and the NPV was 72.7%.For DSA,30 patients with IAD were detected and 1 3 patients had negative results.Compared with the HRGMRI (3 2/43),the coincidence rate of two examinations was 86.0%.McNemer test (P＝0.687)indicated that there was no significant difference between two methods.Conclusion HRGMRI has excellent soft tissue contrast and spatial resolution.As a nonGinvasive modality with good tissue contrast and spatial resolution,it plays an important role in the diagnosis,differential diagnosis and followGup of IAD.

Objective To evaluate the significance of AFP-IgM, this is one of new tumor markers, in the diagnosis of primary hepatocellular carcinoma (PHC). Methods The contents of AFP-IgM and AFP in serum of 103 healthy subjects, 74 patients suffered primary hepatic carcinoma, 27 patients affected by liver cirrhosis and 63 patients affected by chronic hepatitis were detected by means of enzyme linked immunosorbent assay and electrochemiluminescence. No-PHC is comprised of liver cirrhosis,chronic hepatitis and health subjects as control group. Results The area under ROC curve of AFP was larger than that of AFP-IgM (0.85 vs 0.72, Z=3.21) and the best cut-off value of AFP-IgM and AFP was 3×105-AU/L and 10 ug/L respectively, which was determined by ROC curve. Under the cut-off value, the sensitivity of AFP- lgM and AFP for PHC were 64.9% and 79.7%, and the specificity were 75.6% and 80.3%, yet their efficacies were similar. However, for early diagnosis of liver cancer (stage Ⅰ and Ⅱ), the area under ROC curve of AFP-IgM was larger than that of AFP (0.91 vs 0.82,Z=1.73). The sensitivity of AFP-IgM andAFP were 94.4% and 72. 2%, and the specificity were 81.9% and 79.9%. The differences of AFP-IgMand AFP for early diagnosis of liver cancer were statistically significant. When both of the test results combined AFP-IgM with AFP are positive, it can be diagnosed as liver cancer. The specificity of combineddetermination of the two forms was 89.1%, and the efficacy was 79. 0%. Conclusions Both of thesensitivity and specificity of the AFP-IgM test were higher than that of the AFP for early diagnosis of livercancer. We also found that combined determination of the two forms significantly increased the specificityand the positive predictive value for the diagnosis of PHC, thus AFP-IgM was of especially significance forearly diagnosis of liver cancer.

OBJECTIVE: To improve the quality and efficiency of medication consultation and to promote rational drug use in clinic. METHODS: Totally of 520 cases of medication consultation records from the Affiliated Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of TCM during Oct. 2015-Oct. 2016 were selected according to random number table, and then summarized and analyzed statistically in respects of consultation content, age and type of consultants, department, consulted medicine types, the number of combination of TCM and Western medicine, satisfactory degree of consultants, etc. RESULTS: The main consultation contents included usage and dosage (41. 92％), combination of TCM and Western medicine (12. 88％), etc. Consultants mainly aged 50-70 years old (48. 27％), and were mainly the patients and their family members (95. 96％). Consultants were primarily diagnosed in cardiology department and endocrinology department. Top 3 consulted medicine types were cardiovascular system medicines, nervous system medicines, digestive system medicines, and types of Chinese patent medicines were mainly coordinating medicines and activating blood and removing stasis medicines. Types of TCM combined with Western medicine were less than or equal to 3 kinds in 420 cases (80. 77％). Most patients were very satisfied with outpatient medication consultation (93. 65％). CONCLUSIONS: Rational drug use consultation improves medication compliance of patients, meets the needs of patients on medication safety knowledge, and provides a strong guarantee for safe and rational drug use in clinic.